Identification of Rare and Common HPV Genotypes in Sinonasal Papillomas.

Sinonasal papillomas are rare, usually benign tumors arising from the Schneiderian membrane. Human papillomaviruses (HPV) can infect differentiating skin and mucosal cells and can induce uncontrolled growth patterns. Their effect on development of sinonasal papillomas has been discussed controversially in recent years. A monocentric, retrospective study was conducted to investigate histopathologic features of sinonasal papillomas and to establish an assay for HPV detection and genotyping in papillomas. Schneiderian papillomas are divided into three groups according to histopathologic features: the largest group are inverted papillomas, followed by fungiform (exophytic) and oncocytic papillomas. HPV screening was performed with high sensitivity by PCR employing My09/11 and 125 consensus primers. Adding a third primer pair (GP5+/GP6+) d increase sensitivity. Reverse hybridization microarrays achieved HPV genotyping better than pyrosequencing in our setting. HPV infection rates were higher in papillomas (46.7%) than infection rates reported for healthy mucosa (up to 13%). P16(INK4a) was not a reliable surrogate marker for HPV infection in sinonasal papillomas. Data from our study endorses the hypothesis that HPV infection promotes formation of sinonasal papillomas. However, apart from HPV genotypes that are frequently found in e.g. anogenital lesions (such as 6, 11, or 16), tissue samples of sinonasal papillomas also displayed infection with "rare" HPV types (such as 58, 42, 83, or 91).

Prognostic factors and risk factors for development and recurrence of sinonasal papillomas: potential role of different HPV subtypes.

PURPOSE AND METHODS: A retrospective study was conducted to identify and assess potential clinical and molecularbiological risk factors for development and recurrence of sinonasal papillomas (i.e. inverted (IP), fungiform (FP), and oncocytic papillomas (OCP)). Investigated risk factors included age, gender, tumor size and localization, tobacco smoking, regular alcohol consumption, essential hypertension, anticoagulant medication, allergies, surgical approach, and HPV infection. Risk factors were evaluated by regression analysis. RESULTS: Apart from age and incomplete tumor resection, the recurrence of Schneiderian papillomas is independent of conventional risk factors. Patients in this study displayed higher HPV infections rates in IP (38.8%) and in FP (100%) than in healthy mucosa, which is reported 0-5.8% in Germany and central Europe. The proportion of HPV-positive IP decreased with advanced tumor stages: 100% HPV positivity of T1 IP (2/2), 40.9% of T2 IP (9/22), and 35.7% of T3 IP (20/56). Most commonly detected HPV types were HPV 6, 11, and 16; however, patients in this study also displayed HPV types that have rarely or not at all been described in sinonasal papillomas before, such as HPV 58, 42, 83, and 91. Recurrent sinonasal papillomas displayed higher rates of HPV infections than non-recurrent tumors. CONCLUSIONS: Young age at initial diagnosis and incomplete tumor resection are risk factors for recurrence of sinonasal papillomas. Our data suggest that HPV infection supports development and/or perpetuation of sinonasal papillomas. Additionally, sinonasal papillomas seem to display a unique subset of HPV genotypes, including genotypes that have not often been described before.

Physiological parameters of endurance horses pre- compared to post-race, correlated with performance: a two race study from scandinavia.

Few studies have investigated the physiological parameters of endurance horses in Scandinavia. Hence, this two race study has focused on the effects of endurance racing in terms of equine clinicopathological blood parameters, heart score, and fluid use. Race A involved 15 horses (120 km). Two pre- and one post-race blood samples were taken, body condition score was assessed in triplicate pre-race, and an ECG was used to determine heart score. Race B involved 16 horses (65-120 km). One pre- and two post-race blood samples were taken. For both races, horse data as well as fluid intake estimates and cooling water were noted. Race A showed that blood haematocrit, albumin, sodium, and triglycerides increased significantly with endurance racing, whilst chloride, glucose, iron, and potassium decreased significantly. In race B, blood creatinine, cholesterol, and inorganic phosphate continued to increase significantly during the first post-race sampling period compared to pre-race levels, whilst iron, which decreased significantly during the race, increased significantly over the two post-race sampling periods. It is concluded that whilst no correlation between heart score and speed was observed, a significant correlation exists between experience and changes in blood parameters with endurance racing and between fluid intake and average speed.

Ethnicity as a variable in mental health research: a systematic review of articles published 1990-2004.

The objective of the study was to investigate how the ethnic variable has been used in mental health research, in theory, in measurement and classification criteria. Journal articles published 1990-2004 that address original research on psychopathology, treatment and mental health services and with "ethnic" or "ethnicity" in their title or abstract were selected. The papers were examined for their theoretical definition of ethnicity, how the ethnic data were collected and the criteria used to identify ethnic groups. The use of comparison groups and country of the studies were recorded. A total of 421 papers were identified. An explicit theoretical definition was found in 33 (7.8%) papers. Data collection procedure was mentioned in 248 (58.9%) and 104 (24.7%) papers described how data was converted into ethnic groups. The operationalizations of ethnicity have remained almost unchanged during the 15-year review period. Generally, the ethnic variable was incompletely reported. Confusion regarding which individual or social characteristics ethnicity refers to makes the research findings of limited value in clinical settings, and may continue to create misunderstanding about the effect of ethnicity in clinical contexts.

Effects of breed, gender, exercise and white-coat effect on markers of endothelial function in dogs.

This study examines how systemic biomarkers of endothelial function and nitric oxide metabolism are affected by exercise in dogs. Furthermore, breed variation and white-coat effect have been tested by sampling three different dog breeds both in their home and in a clinical setting. Short-term exercise increased plasma nitrate and nitrite (NOx) and von Willebrand factor (vWf). There was significant difference between Pointers and the small dog breeds Cairn Terriers and Cavalier King Charles Spaniels in the general plasma levels of vWf and asymmetric dimethylarginine (ADMA). NOx and vWf were significantly higher when the sample was taken in the laboratory cf. at home, whereas ADMA and L-arginine were significantly lower. In conclusion, both short-term exercise and white-coat effect influence several plasma markers of endothelial function depending also on the breed and gender of the dogs. These findings should be considered in future studies concerning endothelial function in dogs.

Gendered personality dispositions, hormone values, and hot flushes during and after menopause.

The study aim was to test the relationship between gendered personality dispositions (GPD), sex hormones, and vasomotor complaints in the menopausal transition. Fifty-seven healthy women (mean age 51.1 years, standard deviation 2.0) were drawn from a population registry. At enrollment all women were menstruating regularly, and all women reached menopause in the course of the study. Questionnaire data and blood samples were collected once a year over a period of five years. GPD scores (based on the Bem Sex-Role Inventory, BSRI), frequencies of hot flushes and hormone data (estradiol, follicle-stimulating hormone, luteinizing hormone, testosterone, androstendione and dehydroepiandrostendione sulfate) were determined. Subjects were placed into four categories based on the BSRI: masculine, feminine, androgynous and undifferentiated. GPD did not change during the menopausal transition. Testosterone and androstendione were related to GPD in that testosterone and androstendione were higher in the sex typed categories (masculine and feminine) than in the non sex-typed categories (androgynous and undifferentiated). GPD are related both to androgens and to vasomotor complaints such as hot flushes during the menopausal transition, but the mechanisms of these relationships are not known.

[Can psychological treatment help patients with cancer?]. / Kan psykologisk behandling hjelpe kreftpasienter?

BACKGROUND: A number of studies have shown that psychological interventions may supplement the medical treatment of cancer patients by reducing psychological morbidity and increasing their quality of life. However, previous literature reviews point to methodological flaws limiting the specific and definite conclusions that can be drawn with respect to intervention effects. MATERIAL AND METHODS: Through searches in Medline, Embase and PsycINFO, the present study aims to review recent controlled studies from 1992-2000. RESULTS: Of the ten studies identified, seven reported effects of cognitive, psycho-educational and supportive treatment of various forms of cancer. INTERPRETATION: As found in the previous literature reviews, methodological shortcomings limit what firm conclusions may be drawn in order to guide clinicians as to what kind of interventions will be cost-effective for specific cancer patient groups. Nevertheless, the present as well as the previous reviews indicate that psychological treatment of cancer patients should be continued and that more well-controlled studies should be conducted.

Seasonal eating patterns in Norway: a non-clinical population study.

Seasonal deviations in normal eating habits have been associated with seasonal affective disorder (SAD) and bulimia nervosa (BN). Two studies on seasonal variation in eating habits are reported in this paper. In Study 1, seasonal patterns of eating disturbances were measured cross-sectionally in 6313 participants using an eating disturbance scale (EDS-5) and a modified version of the Seasonal Pattern Assessment Questionnaire (SPAQ). Eating disturbance scores were predicted by seasonal sensitivity scores from the SPAQ, gender, age, and light. Study 2 used a longitudinal design in which 908 participants were given the EDS-5 every month from November 1993 to January 1995. Scores on the EDS-5 fluctuated with the season of the year, with higher EDS-5 scores in winter and lower in summer. The results suggest that seasonal fluctuations affect only a subset of the total population.

Potential role of parasitism in the evolution of mutualism in astigmatid mites: Hemisarcoptes cooremani as a model.

Phoresy is a symbiotic interaction that results in dispersal, benefiting the relocated organism without negatively impacting the phoretic host. It has long been considered that phoresy among astigmatid mites is somehow an intermediate precursor to the evolution of parasitism within the group. In astigmatid mites, only the heteromorphic deutonymph (hypopode) participates in phoretic dispersal, and the plesiomorphic hypopode may be the key to understanding the dynamics of the evolution of that parasitism. Hypopodes of Hemisarcoptes cooremani (Acari: Acariformes) and their phoretic beetle host Chilocorus cacti (Coleoptera: Coccinellidae) have become the experimental focus for studies concerned with the potential forces that influence the transition of a free-living life style into various coevolved relationships. Previous radiolabeling studies applied to H. cooremani and C. cacti determined that hypopodes of H. cooremani acquired resources from adults of C. cacti while in transit, negating the paradigm that the heteromorphy was purely phoretic. To further probe this relationship, we tested whether materials could be passed from the mites to their hosts. We report here a study using a tritium radiolabel, which indicated that beetles also acquire resources from the hypopodes. These results have implications for understanding the complex relationship between H. cooremani and C. cacti. We propose that this relationship should now correctly be defined as mutualistic (not phoretic) and develop a general model for the potential role of parasitism in the evolution of mutualism among the Astigmata.

[Psychosocial follow up after parasuicide at hospital departments in Norway]. / Psykososial oppfølging etter parasuicid ved medisinske sykehusavdelinger i Norge.

BACKGROUND: Routines and standards of care for parasuicide patients in general hospitals in Norway were reviewed in relation to international and national recommendations. MATERIAL AND METHODS: Telephone interviews were conducted with personnel at all Norwegian general hospitals with emergency units. 55 of a total of 58 hospitals participated (95%). RESULTS: Two thirds of the hospitals reported that most parasuicide patients were routinely psychiatrically evaluated and then referred to psychiatric or community aftercare. At almost half of the hospitals (46%) the staff had not received any specific training in clinical management of parasuicide patients during the last three years. Structured collaboration with external aftercare providers was non-existent in 43% of the hospitals. Hospitals with projects aimed at psychosocial follow up of parasuicide patients or hospitals with a team or a person responsible for the follow-up, had, however, routines more in accordance with the recommendations than hospitals without projects or teams. INTERPRETATION: The study shows great variations between Norwegian general hospitals in their routines and standards of care for psychosocial follow-up of parasuicide patients. Increasing the staff's competence, developing written routines and establishing mutually binding co-operation between the hospital and external caregivers are important areas for further development.

The endocrine transition around menopause--a five years prospective study with profiles of gonadotropines, estrogens, androgens and SHBG among healthy women.

OBJECTIVE: The purpose of this study was to investigate the hormonal changes during the menopausal transition in a non-clinical population. METHODS: Fifty-nine healthy Norwegian women participated in a five year prospective longitudinal study during the transition from pre- to post-menopause, starting one to four years before menopause, and ending one to four years postmenopausal. None of these women were given hormone replacement therapy (HRT). Blood samples were collected every 12 months and luteinizing hormone (LH), follicle stimulating hormone (FSH), steroid hormone binding globuline (SHBG), prolactin (PRL), estradiol (E2), estrone (E1), testosterone, androstendione, dehydroepiandrostendione-sulphate (DHEA-S), and thyroid stimulating hormone (TSH) were analyzed. RESULTS: The serum levels of FSH and LH, E2 and E1 profile essentially confirmed previous data obtained in cross-sectional studies. A continuous increase in serum FSH and LH and a concomitant fall in E2 and E1 were observed in all women before menopause and in the two postmenopausal years. Both androstendione and testosterone showed a decline three years before menopause. After the menopause, however, there were fluctuations in the testosterone levels. Androstendione correlated positively with both E2 and E1 and testosterone postmenopausally. Body mass index (BMI) did correlate with testosterone, but not with androstendione. BMI correlated negatively with SHBG. No correlation was found between BMI and E2, E1, FSH and LH. CONCLUSION: This longitudinal prospective study of hormonal changes during the transition from pre- to postmenopause indicates that not only estrogen hormonal changes, but androgen hormonal changes as well, precedes the menopause by several years.

Menopause, mood and hormone replacement therapy: methodological issues.

In this paper a number of methodological issues relating to research on the relationship between the menopause, mood and hormone replacement therapy (HRT) are discussed. These issues relate to problems of design and statistical analyses, problems which have prevented the reaching of definite conclusions regarding the relationship between menopause, mood and hormones. These problems are discussed under three main headings, namely, the assessment of menopausal status, statistical modelling and the design and analyses of clinical trials. Problems relating to concepts and measurement of dependent variables are the subject matter of the papers that follow. Within the three main headings more specific issues are detailed. The paper concludes with a list of recommendations on how research in this important area might be further advanced.

Analyzing the relation between self-esteem and eating disorders: differential effects of self-liking and self-competence.

Research in the past has demonstrated an association between low self-esteem and eating disorders. Recent research on self-esteem has shown, however, that self-esteem is composed of two distinct factors--self-liking and self-competence. The present study examined the relation between these two self-esteem factors and both eating disorders and eating disturbed cognitions. A total of 51 female participants from a high-risk population were clinically interviewed to identify the eating disorder and administered a series of questionnaires that included a measure of self-liking and self-competence. A strong relationship was found between self-liking and eating disorders, but no relationship was found between self-competence and eating disorders.

Leisure-time physical exercise: prevalence, attitudinal correlates, and behavioral correlates among young Europeans from 21 countries.

BACKGROUND: Increasing leisure time physical exercise is a major target of public health programs throughout the developed world, but few international comparisons of exercise habits among people from diverse cultures have been published. The objectives of this study were to assess the prevalence of exercise among young adults from 21 European countries, to analyze associations with health beliefs and risk awareness, and to investigate relationships among exercise, other health-related behaviors, and emotional well-being. METHODS: The European Health and Behaviour Survey, a questionnaire survey of 7,302 male and 9,181 female university students ages 18-30 years from 21 countries, was analyzed. RESULTS: Age-adjusted prevalence of physical exercise in the past 2 weeks averaged 73.2% among men and 68.3% among women, but varied markedly from more than 80% to less than 60% across country samples. Beliefs in the health benefits of exercise were consistently associated with physical exercise, as was desire to lose weight. Awareness of the influence of exercise on heart disease averaged 52% among men and 54% among women, but was not strongly associated with engagement in exercise. Associations among exercise, lack of smoking, and sleep time were observed, but results for alcohol consumption were inconsistent. Social support and depression were independently associated with physical exercise. CONCLUSIONS: Physical exercise levels are highly variable across samples of relatively privileged young Europeans from different countries. Associations with other health behaviors and with emotional well-being suggest that regular physical exercise is consistent with a healthy lifestyle. Links with health beliefs are consistent despite sociocultural differences, but deficient knowledge of the health consequences of a sedentary lifestyle remains a cause for concern.

Disqualifying family communication and childhood social competence as predictors of offspring's mental health and hospitalization. A 10- to 14-year longitudinal study of children at risk of psychopathology.

Forty-nine families from the University of Rochester Child and Family Study were followed up 10 to 14 years after initial assessment. Two inclusion criteria were applied: at least one of the parents had been hospitalized for a functional psychiatric disorder before initial assessment and, second, the male index offspring should be 18 years or older at follow-up. Initial measures included observationally based coding of the family's level of disqualifying communication toward the index offspring, index child's scores on the Child Manifest Anxiety Scale, and ratings of the index child's social competence carried out by peers, teachers, and parents. Offspring outcome was measured by the Mental Health Inventory, Global Assessment Scale (GAS), and hospitalization for psychiatric disorder. The results showed that every measure of offspring outcome was predicted by the amount of disqualification directed to the offspring from the other family members. In addition, GAS score and mental health were predicted by the offspring's competence as a child. Family disqualification, childhood competence, and socioeconomic status accounted for 63% of the variance in adult GAS scores.

Confirmatory and disconfirmatory family communication as predictor of offspring socio-emotional functioning. A 10 to 14 year follow-up of children at risk.

Forty-nine families from the University of Rochester Child and Family Study were followed up 10 to 14 years after initial assessment. Two inclusion criteria were applied: at least one of the parents should have been hospitalized for a functional psychiatric disorder before initial assessment and the male index offspring should be 18 years or older at follow-up. Family communication was observed by the Consensus Rorschach procedure and coded with the Confirmation-Disconfirmation Coding System. Offspring childhood social competence was rated by peers, teachers and parents. Outcome measures included the Denver Community Mental Health Questionnaire, the Global Assessment Scale and hospitalization for a psychiatric disorder. Results showed that the family's level of confirmation and disconfirmation communication during Consensus Rorschach at initial testing predicted offspring interpersonal functioning and hospitalization for psychiatric disorders. These findings were not due to the initial social competence or IQ of the child, the level of functional impairment in parents or their social class.

Trends in the use of climacteric and postclimacteric hormones in Nordic countries.

The extent of menopausal and postmenopausal hormone use in Denmark, Finland, Norway, and Sweden during 1981-1992 was studied by means of drug sales figures and associations between hormone use, education, employment and occupational status, by questionnaire surveys in each of the respective countries in the 1980s-90s. According to sales figures, hormone use has been different in each of the countries studied. In 1981 use was three times more common in Denmark than in Norway. In 1992 use had increased in all the other countries except Denmark, and was highest in Finland and Sweden. Based on 1981 data for Norway, on 1987 data for Denmark and on 1989 data for Finland, use of hormone therapy was related to education, employment or occupational status in Finland but not in Denmark or Norway. Differences in the phases of innovation diffusion between these countries may offer a partial explanation for these results.

Fusion in the parent relationship of schizophrenics.

Parents of schizophrenics have increasingly been included in the treatment of their offspring, either in psychoeducational oriented approaches (Anderson et al. 1980) or in regular family therapy (Hoffman 1981). However, the success of such interventions may depend on the nature of the parental relationship. Furthermore, in designing treatment programs for schizophrenics that include their parents, the particularities of the parental relationship need to be taken into account. Hence, descriptions of the relationship between parents of schizophrenics should be valuable for the clinician. Providing such descriptions is the general aim of the present study.

[A new teaching program in behavioral sciences in Oslo]. / Nytt undervisningsopplegg i medisinske atferdsfag i Oslo.

The Department of Behavioural Sciences in Medicine at the University of Oslo was established in 1977. The teaching programme followed the same main principles until 1992, and took place in the third and fourth terms. Since 1992, however, several changes have taken place. The teaching is now given together with medical history during ten weeks at the end of the preclinical term. Teaching practical skills in doctor-patient communication is introduced in this term, and is continued in the first clinical year. The students work together in plenary seminars on the main topics presented in the lectures. The teaching is still concentrated on four main topics: Psychobiology, medical psychology, medical sociology and the doctor-patient relationship and communication. We conclude that the changes have improved the teaching. Written evaluation by the students strongly supports this conclusion.

Disqualifying family communication and anxiety in offspring at risk for psychopathology.

The association between disqualifications in parental and family communication and manifest anxiety in boys (7 or 10 years) was investigated. The sample consisted of 59 families where one of the parents had previously been hospitalized for a functional mental disorder. Parental and family communication was observed in the Couples Rorschach (CR) and Family Rorschach (FR) tasks, respectively. The results showed that the amount of one particular type of disqualification, self-disqualification, correlated positively with the boy's anxiety level. Self-disqualification refers to utterances in which the speaker communicates in vague, egocentric or paradoxical ways, which makes it impossible for the receiver to know what has been said. This correlation was evident both with respect to the communication between the parents during CR and the communication from the family to the index boy during FR. The relationship between self-disqualification and anxiety was attributable to neither the boy's age or intelligence quotient nor the dimensions of parental psychopathology or functional impairment.